Journal of the Boston University School of Medicine Historical Society FAAall 2012 CCEESSOO F I I a n n l Modern Medicine: l 2 6 a The Hapsburgs in the Time of Cholera: a The 1873 World’s Fair in Vienna 0 1 2 Kyle Pronko u u g g V 8 The Making of a Public Health Campaign: o l u u Public Perception in Shaping London’s Sanitation Reform u m Cecilia Vu e 1 r r , I a s a s u 10 What War is Good For: e 1 l The United States and the Cuban Health Revolution l Daniel Solomon I I s s s Feature: s u 15 A Psychiatrist Looks at Mary Lincoln u James S. Brust, MD e e : Ancient World: : 23 A Medical History: C Thucydides and Historiography C Michael Sherman o o n Ethics: n 26 “Our Message is Unequivocal”: t The Stake of Physician Advocacy in Reproductive Health t e Ashish Premkumar e n n Book Reviews: t 30 t Rabies, a Virus to Remember s By Bill Wasik and Monica Murphy s Reviewed by Sara M. Bergstresser, PhD MPH Aceso 2 About the Cover The Things We Take With Us: The cover picture depicts a homoeopathic medical kit, circa 1870. In 1874 the Massachusetts Homeopathic Hospital moved into a newly­built Talbot Building in Boston's South End. It later abandoned homeopathic practices, and in 1929 became part of Massachusetts Memorial Hospital. This was eventually merged into the Boston University Aceso: Medical Center, now part of Boston Medical Journal of the Boston Center. The Talbot Building now houses the University School of Medicine Boston University School of Public Health. Historical Society Note the vial of Digitalis in the top left. The drug is an inhibitor of sodium­potassium Founder & Michael Sherman ATPase extracted from the foxglove plant. Editor­in­Chief Digitalis has been used as a medication to treat congestive heart failure for hundreds of years. Contributing Editor Kyle Pronko In the past, a doctor’s bag provided both the Copy Editor Peters Otlans function of a repository of medication and tools, as well as a symbol of the office. In the Faculty Advisor Robert Beazley, MD modern practice of medicine the physician’s bag has all but been eliminated from practical use and this symbol of the things carried into Email: [email protected] practice has disappeared. Yet the thing that each physician carries with them internally Aceso welcomes letters to the editor, please send them remains ­ their background, biases, experiences, by email. Please note that content can only be education and more. reproduced with permission of the author. Join the Aceso Staff Interested in getting involved with Aceso? We are Design Editors and graphic designers create the actively looking for new Editors and Graphic cover, layout the format, and manage the artwork of Designers to join our staff. We are recruiting for this Aceso. This position requires either some art or upcoming semester so spread the word! design experience. Editors take part in shaping the overall direction of If you are interested in applying for one of these Aceso and review the articles submitted by our positions, please email us at [email protected] and let writers. This position requires the staff member to us know what position you are applying for. have excellent writing and strong spelling skills. Aceso 3 About Aceso This journal is named for a Greek goddess Aceso, the daughter of Asclepius and sister of Panacea. Her name comes from the Greek word akéomai, which means "to heal." She represented the act of the healing process itself. Unlike the other gods, she personified medicine from the patient’s side, a process that involved both the ill and the physician. Rather than a magic cure, personified by Panacea, Aceso was more involved in overall care and the realization that healthcare and well­ being took time and the effort of an active process. Letter from the Editor The Things We Take With Us: It is my pleasure to introduce the inaugural issue of application of science to diagnose and treat disease. Aceso: Journal of the Boston University School of While science remains incomplete there is a Medicine Historical Society. I hope you enjoy this demonstrated benefit to the treatment of disease publication as much as the staff, editors, writers, using medicinal science. And while we know and I had in assembling this journal. I feel much, much also remains unknown. Mechanisms obligated though to share a thought on why I felt of action that remain elusive, interventions that this journal was necessary. work but are not perfectly understood, presentations that are obscure, variables that cannot In a place devoted to the study of ‘hard’ science, it be calculated, differentials that are incorrect, is not always easy to find interest in the humanities. treatments that work for some have no or little We are more concerned with the practical, that effect on others – these complicate the practice of which is immediately relevant. And we are not the art. wrong to focus on such either. A tremendous amount of knowledge and skill must be transmitted Thus medicine finds itself in the strange position in a efficient manner to train professionals who will where one is compelled to act using incomplete be engaged in deadly serious endeavor. information and an imperfect understanding. As Furthermore, the system is designed to self­select Sun Tzu would say, we know ourselves and our for the serious student of physical and biological enemies’ imperfectly and as a result the outcomes sciences. Yet, as I have been told time and again, are not always guaranteed. What fills the gap in medicine is not a science, it is an art. But what does understanding is the physician, the person. What that mean? they bring with them to the table is more than just science; it is compassion, reason, emotion, It is said that if you know your enemies and know experience, dedication, determination, and so much yourself, you will not be imperiled in a hundred battles; more that make us human. It is this reason that the if you do not know your enemies but do know yourself, humanities should not be neglected. As I make the you will win one and lose one; if you do not know your case that the humanities have gained from science enemies nor yourself, you will be imperiled in every (A Medical History, pg 23), perhaps the science of single battle. ~Sun Tzu medicine can also learn from humanities. Simply put, science is the accumulation of Michael H. Sherman knowledge, as of yet incomplete. Medicine is the BUSM Class of 2015 Aceso 4 Aceso Submissions Are you interested in History and Medicine? Aceso: The Journal of the BUSM Historical Society is accepting submissions for next spring’s issue. We are looking for contributions in the fields of: • Medicine in Antiquity • History of Medicine • s History of Public Health and related field • History of Medical Education • History of BUSM • History of BMC and Boston City Hospital • History of Medicine in Boston • Biographical Essays • Ethics/Editorials • General Medical History • Book Reviews If you have an interest in these topics or a suggestion for another topic and would like to write an article please contact us at: [email protected] About the Art Unless noted, pictures throughout this issue are from the archives of the Alumni Medical Library of Boston University School of Medicine. Special thanks to A'Llyn Ettien for allowing us to access the archives. Aceso 5 Modern Medicine The Hapsburgs in the Time of Cholera: The 1873 World’s Fair in Vienna Kyle Pronko MD Candidate 2015 Boston University School of Medicine istorians often ascribe the amazed external observers.”[1] reader to see for himself the work course of human events A bright point on the Austria­Hungary had done to to the giants of history, empire’s horizon was the 1873 maintain its power and world huge personalities like World’s Fair, or Weltausstellung, which standing; however, by doing so the Napoleon, Alexander the was to be held in Vienna. At that time, author was by necessity confirming HGreat, and Ghengis Khan. However, the great cities of London and Paris that the common belief of the day was history’s smallest players – microbes – were the only other cities that had that the Hapsburg Empire was one have had a hand in some of the largest held expos,[2] so it was an honor for where finding magnificence would be events. From the Plague of Athens to the capitol of the declining empire to surprising. the Black Death to the Spanish Flu, be held in such company. The fair Expectations surrounding the viruses and bacteria have often driven was also a chance for Austria­ fair were high and excitement human history. Cholera could also be Hungary to prove that it was still a preceding the event could be found added to that list, as it had a role in relevant power, a chance for the worldwide, even reaching the United bringing down one of nineteenth empire to show off what it could still States. New York Times “special century Europe’s largest empires. do. Emperor Franz Joseph himself, in correspondent” H.J.W. began an The Hapsburg Empire a speech given on November 5, 1873 at article about the upcoming event in a experienced a period of slow decline a ceremony for the World’s Fair, gave gushing manner: in the late nineteenth century. A the fair credit for “[raising] the Vienna – the gay and beautiful capital of the Polyglot Hungarian revolt in 1848, a lost war standing and position of the [sic] empire of Austria, the city of palaces, the refuge against Sardinia and France in 1859, monarchy amongst the league of of exiled royalty, and the Paris of Germany – promises to be the Mecca during the Summer of and a crushing defeat by Prussia in nations.”[3] An uncited New York 1873, of a pilgrimage grander than that which poured 1866 were all low points.